title: Imaged guided transarterial chemoembolization with drug-eluting beads loaded with doxorubicin (DEBDOX) for hepatic metastases from melanoma: early outcomes from a multi-institutional registry.
abstract: Patients with unresectable hepatic metastases from melanoma present a difficult clinical challenge due to lack of locoregional control and poor response to systemic chemotherapy. This study aims to examine the early outcomes of the novel treatment of unresectable hepatic metastases from melanoma with drug-eluting beads loaded with doxorubicin (DEBDOX) delivered via image guided transarterial chemoembolization. A multicenter prospective open registry of hepatic-directed therapy with drug-eluting beads was reviewed. Six patients underwent 12 DEBDOX treatments for liver-predominant, unresectable metastases from melanoma. Six adverse events (grade 1 or 2) were exhibited in three patients and were most commonly emesis, nausea, and pain. Over a median follow-up of 12 months (range: 6-17), response rates of 100 per cent, 83 per cent, and 60 per cent were observed at 3, 6, and 9 months respectively, based on standardized computed tomographic criteria. A median survival of 12.3 months after initial DEBDOX treatment was observed. Initial results for liver-directed therapy of hepatic-dominant metastatic disease from melanoma with DEBDOX demonstrate that this is a safe and well-tolerated treatment option with favorable response rates and survival characteristics at this point in follow-up. Salvage therapy with DEBDOX should be considered in the multidisciplinary therapy for this clinical dilemma.
authors.affiliation: Department of Surgical Oncology, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Russell E
authors.initials: RE
authors.lastname: Brown
authors.forename: Kaitlin M
authors.initials: KM
authors.lastname: Gibler
authors.forename: Tiffany
authors.initials: T
authors.lastname: Metzger
authors.forename: Igor
authors.initials: I
authors.lastname: Trofimov
authors.forename: Henry
authors.initials: H
authors.lastname: Krebs
authors.forename: Francisco Diaz
authors.initials: FD
authors.lastname: Romero
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D012042:Registries; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin